Term
| Verapamil- MOA & Indications |
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Definition
Blocks Ca channels on VSM of arteries
*Vasodilation of peripheral arteries- decreased arterial pressure
*vasodilation of coronary arteries
Blocks ca channels in heart
*decreased HR, force of contraction and conduction
Indirect Effect
No change unless underlying cardiac disease
Indicated for: Angina, HT, dysrhythmias (supraventricular), migraine prophylaxis |
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Term
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Definition
Consipation- most common
Vasodilation- dizziness, edema, etc
Gingival hyperplasia
Cardiac effects (high dose or predisposing factors)
Heart Block
Bradycardia |
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Term
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Definition
Calcium Channel Blocker
MOA similar to verapamil, but less potent effects on heart
ADR's similar but less incidence |
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Term
| Nifedipine- MOA & Indications |
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Definition
Calcium Channel blocker
Blocks Ca channel in arterial VSM, activates baroreceptor reflex -> vasodilation
*decreases BP, increased HR and contractile force
Indications- Angina, HT |
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Term
| Nifedipine- ADR's/metabolism |
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Definition
Vasodilaton, flushing, dizziness, edema, etc *almost all dihydrop. get edema
Reflex tachycardia may aggravate angina
May have SA/AV node block or negative inotropic effects
hepatic metabolism |
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Term
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Definition
| -dipine, all similar to nifedipine |
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Term
| What 3 drug categories have been proven to decrease premature death from HT? |
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Definition
| Diuretics, B blockeers, ACEI |
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Term
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Definition
-olol, some selective for B1, some lipophilic (so CNS effects)
Reduces HR and force |
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Term
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Definition
-osin
Cause vasodilation so reduced BP |
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Term
| Centrally acting a2 agents for HT |
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Definition
Clonidine, Guanabenze, Guanfacine, Methyldopa (all similar)
a2 agonists -> reduce sympathetic output from brainstem to periphery
ADR's- rebound HT, drowsiness |
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Term
| Diuretics, non potassium sparing |
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Definition
Thiazide diuretics usu used.
Block Sodium and Clorine absorption in distal convoluted tubule- less water reabsorbed
decrease BV so decreased BP |
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Term
| Diuretics- potassium sparing- for HT |
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Definition
Eplerenone, spironolactone- aldosterone antagonist -> inhibits Na/K exchange, less water reabsorbed
Triamterene & Amiloride- direct inhibition of NA/K exchange |
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Term
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Definition
ACEI- "-pril"
Block enzyme that converts angiotensin 1 to 2. Angiotensin 2 causes vasoconstriction, so blocking it causes vasodilation.
ARB "-sartan" angiotensin 2 antagonist
Aliskiren- direct renin inhibitor |
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Term
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Definition
Most commonly used are thiazide or thiazide like, and loop agents
Spironolactone- K sparing diuretic that caused significant decrease in mortality rate and SS for HF |
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Term
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Definition
| Angiotensin II contributes to remodeling of heart tissue |
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Term
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Definition
MOA not understood
Start dosage low and increase slowly, easy to get ADR
carvedilol, bisoprolol, metoprolol |
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Term
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Definition
MOA- Inhibits NA/K/ATPase pump -> Ca normally flows out during repolarization, inhibition of pump indirectly causes Ca to stay in longer ->more contraction
Effects- positive inotropic, increased CO, decreased sympathetic tone (decreases tachy and afterload & preload).
Increased urine production |
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Term
| Digoxin- cautions and ADR's |
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Definition
cautions- hypokalemia -> increased action of digoxin & possible toxicity
Heart diease- risk factor for toxicity
ADR- may cause dysrhythmias *watch for pulse <55-60 and different rhythm*
GI (A/N/V)
CNS (HA, fatigue, disturbances)
Visual disturbances |
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Term
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Definition
Antidysrhythmic drug
Slows impulse conduction & deplays repolarization
anticholinergic
Used for supraventricular & ventricular dysrhythmias
Hepatic metabolism
short acting and sustained release
ADR- Diarrhea, Cinchonism (tinnitus, HA, N, etc), Cardiotoxicity, Hypotention, hypersensitivity |
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Term
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Definition
Antidysrhythmic
Similar to quinidine, but less anticholinergic
Hepatic metabolism and renal excretion
ADR- SLE (common), blood dyscrasias (decreased plt and WBC, rare), cardiotoxicity, GI, hpotension, allergy |
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Term
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Definition
Antidysrhythmic
Slows conduction
Used only for ventricular dysrhythmias, esp after MI or due to Digoxin
IV or IM (huge first pass)
ADRs- mostly CNS (drowsiness, confusion)
Not pro-dysrhythmic |
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Term
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Definition
Antidysrhythmic
Effects similar to lidocaine
Must raise dose slowly d/t liver enzyme saturation
IV
ADR's- CNS (nystagmus, sedation, cognitive impairment), gingival hyperplasia, skin rash, hypotension, phlebitis
not pro-dysrhythmic |
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Term
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Definition
Antidysrhythmic
Orallly bioavailable derivative of lidocaine
used if unresponsive to other agents
Most stop drug due to SE
ADR's- GI, neurologic (tremor, convuslsions, psychosis)
not pro-dysrhythmic |
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Term
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Definition
Antidysrhythmic
orally bioavailable derivative of lidocaine
used if unresponsive to other agents
ADR's- blood dyscrasias, pulmonary fibrosis
not pro-dysrhythmic |
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Term
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Definition
non-selective B Blocker used for antidysrhythmia
used for tachydysrhythmias, esp ones caused by sympathetic stimulation
ADR's- AV block, bronchospasm, HF, senus arrest |
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Term
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Definition
B1 specific B Blocker used for antidysrhythmic
Oral and still causes bronchospasm |
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Term
|
Definition
B blocker used for antidysrhythmic
IV, very short half-life |
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Term
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Definition
Used for refractory patients/severe casaes
Accumulates in many tissues, esp in overweight pts
Hepatic metabolism with biliary excretion
Half-life is in months
ADR- "Too much of good thing...". Cardiac (bradycardia, AV block, HF, pro-dysrhythmia), pulmonary fibrosis, corneal deposits, blue-gray discoloration of skin, GI, CNS (tremor, mood alteration), hepatotoxicity, thyroid dysfunction |
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Term
| -statins, MOA and Effects |
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Definition
HMG CoA reductase inhibitors
causes liver to increase # of LDL receptors
Effects- decreased LDL (better than other classes), increased HDL (moderate), decreased TG (moderately)
metabolized in liver |
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Term
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Definition
| ADR's- initial & transient (HA, rash, GI), serious & dose related (hepatotoxicity [must moniter], myopathy [deposition of muscle breakdown in kidney, watch for muscle pain and weakness]), peripheral neuropathy |
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Term
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Definition
MOA- VLDL synthesis
Effects- lower TG (best), lower LDL, higher HDL (good)
ADR- skin flushing/itching, GI, hepatotoxicity, hyperglycemia.
Also available in combination product |
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Term
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Definition
Cholesterol lowering, Bile acid- binding resin
MOA- decreased absorption of bile acids which are made f/ cholesterol
Effects- lower LDL levels (delayed), increased HDL (moderate).
Usu. combined with -statin
ADR's- constipation, decreased absorption of fat-soluable vitamins |
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Term
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Definition
Cholesterol lowering, Bile acid- binding resin
MOA- decreased absorption of bile acids which are made f/ cholesterol
Effects- lower LDL levels (delayed), increased HDL (moderate).
Usu. combined with -statin
ADR's- constipation, decreased absorption of fat-soluable vitamins |
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Term
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Definition
Cholesterol lowering, Bile acid- binding resin
MOA- decreased absorption of bile acids which are made f/ cholesterol
Effects- lower LDL levels (delayed), increased HDL (moderate).
Usu. combined with -statin
ADR's- constipation, decreased absorption of fat-soluable vitamins |
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Term
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Definition
Cholesterol lowering- fibric acid
MOA- not understood
Effects- lower TG (good as niacin), lower LDL, increased HDL
Major use is to lower TG
Usu in combination
ADR's- Rashes/GI (mild), gallstones (rare), myopathy, hepatotoxicity |
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Term
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Definition
Cholesteral lowering
MOA- blocks choesterol absorption in GI
Metabolized to active form in liver, eliminated in bile
ADR's- none significant, very new drug |
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Term
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Definition
MOA- cause venous dilation, decreased preload & O2 demand
reduces coronary vasospasm
ADR's- headache, orthostatic hypotension, reflex tachy
Tolerance- forms after several hours due to depletion of sulfhydryl groups, MUST have drug free period for at least 6-8 hours/day
Many different dose forms and routes |
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Term
|
Definition
Decrease O2 demand- only for exertional angina
ADR's- decreased HR/AV conduction, lower BP, asthmatic effects |
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Term
| Calcium Channel Blockers for angina |
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Definition
For both exertional and variant
ADR's- Lower HR/AV conduction, lower BP, reflex tachy, constipation |
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Term
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Definition
Angina
MOA- prevents inappropriately high intracellular calcium- reduces cardiac work
Only for prevention of angina
ADR's- dizziness, HA, constipation, prodysrhythmic |
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Term
|
Definition
| Thrombolytic drugs for MI |
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Term
| Drug regimen on discharge after MI |
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Definition
Aspirin (w/ clopidogrel if PCI w stent) or warfarin
B blocker
ACEI
-statin |
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Term
| Classes of antiarthritic drugs |
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Definition
| NSAIDs, DMARDs, glucocorticoid/corticosteroids |
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Term
|
Definition
First choice DMARD
Most rapid acting
ADR's- hepatic fibrosis, bone marrow suppression, GI ulceration, pneumonitis |
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Term
|
Definition
first choice DMARD
fairly rapid acting
may have retinal damage |
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Term
|
Definition
first choice DMARD
not as effective for RA
ADR's- serious ones rare, compliance limiting GI and dermatologic |
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Term
|
Definition
Reserved DMARD
MOA- inactivates TNF, reduces inflammation that causes joint damage
ADR's- Infection, injection site reactions |
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Term
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Definition
Reserved DMARD
blocks TNF
IV only
ADR's- infection |
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Term
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Definition
Reserved DMARD
blocks TNF
Sub-q
ADR's- infection |
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Term
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Definition
reserved DMARD
decreases T cell proliferation
ADR's- infection, D/N, rash, alopecia |
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Term
|
Definition
Reserved DMARD
Blocks IL-1, which reduces inflammation
infection |
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Term
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Definition
Reserved DMARD
blocks TNF
Infection |
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Term
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Definition
Reserved DMARD
Inhibits T cell activation |
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Term
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Definition
Reserved DMARD
inhibits B cell activation |
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Term
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Definition
Reserved DMARD
IL-6 antagonist
only for RA patients who did not respond to TNF antagonist
Infection |
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Term
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Definition
Gout
Reduces blood levels of uric acid by blocking anzyme that metabolizes precursors
Use- chronic tophaceous gout
hyperuricemia due to chemo
ADR's- hypersensitivity, GI, neurologic (drowsiness, HA), cataracts |
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Term
|
Definition
Gout
Similar to allorpurinol
less hypersensitivity reactions
possible cardiovascular/thromboembolic ADR |
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Term
|
Definition
Gout
Increases urinary excretion of uric acid
long term prevention only
ADR's- GI, hypersensitivity, kidney stones (must drink lots of water). |
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Term
| Benefit of spacer in Asthma |
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Definition
| More medication into lungs, so fewer s/e |
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Term
| Types of inhalation drug therapy for asthma |
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Definition
| Metered Dose inhalers (w/ or w/o spacers), dry powder inhalers, nebulizers |
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Term
|
Definition
Inhaled glucocorticoids
anti-inflammatory
ADR's local- Oropharyngeal candidiases and dysphonia
Gargle & use spacer to prevent
ADR's systemic- Osteoporosis, retarded rate of growth, cataracts and glaucoma |
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Term
|
Definition
relieves bronchospasm
prevention and acute attack
ADR's- tremor, tachycardia, hypokalemia
Inhaled or oral
long acting usu w/ glucocorticoid |
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Term
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Definition
Asthma prevention
supresses inflammation
Inhalation only
Safest of all anti-asthma |
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Term
|
Definition
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Term
|
Definition
Antimuscarinic for asthma
MDI and nebulizer
ADR's- mostly local (dry mouth, throat irritation) |
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Term
|
Definition
| Similar to Ipratropium, longer acting |
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Term
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Definition
Methylxanthine for asthma
MOA not established
narrow therapeutic index
quick and sustained (preferred) release
ADR's- GI, CNS, CV (tachy, dysrhythmias, angina) |
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Term
|
Definition
Asthma- leudotriene modifier (bronchodilator)
Short acting |
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Term
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Definition
Asthma- Leukotriene modifer (bronchodilation)
short acting
hepatotoxic |
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Term
|
Definition
Asthma- leukotriene modifier (bronchodilator)
Longer acting zafirlukast, w/o liver toxicity |
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Term
| What drug type do you treat HT w/ 1st? |
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Definition
| diuretic, then add f/ different classes |
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